降氟除氟技术措施推广应用示范研究基线调查结果分析

目的了解拟开展降氟除氟技术措施推广应用示范研究的6个建制村燃煤污染型氟中毒基线情况，为实施和推广降氟除氟技术措施提供科学依据。方法运用历史资料调查6个建制村和所在3个区县的基本情况：运用Dean氏法检查病区县所有病区村的8～12岁儿童氟斑牙患病情况。计算氟斑牙患病率、氟斑牙缺损率、氟斑牙指数；运用氟骨症临床诊断标准检查病区县病区村16岁以上人群的氟骨症患病情况，计算氟骨症检出率；检测儿童尿氟和空气氟，计算尿氟几何均数和空气氟平均浓度；采用问卷调查的方式对6个村进行人户调查，调查村民炉灶使用等情况，计算炉灶改造率、正确使用率。结果6个村8～12岁儿童氟斑牙患病率为70．71％、缺损率为8．54％、氟斑牙指数为1．29，属中度流行；16岁以上成人氟骨症检出率为6．37％，重度氟骨症检出率为0．80％。儿童尿氟几何均数为1．04mg／L，空气氟封火期均值为（0．0037±0．0063）mg／m^3，旺火期均值为（O．0083±0．0067）mg／m^3。能源结构为：燃煤的占93．03％（3269／3514）、使用沼气的占1．79％（63／3514）、液化气等其它占5．18％（182／3514）；以户为单位能够正确使用的户数为1921户，正确使用率为53．29％。学生和居民地氟病防治知识知晓率分别为78．16％和62．95％。结论选取的6个村属燃煤型氟中毒流行区，符合降氟除氟技术措施实施和示范推广要求。在这些地区采取继康教育宣传，提高居民的健康意识，改变防病观念，并根据不同病区类型、经济状况、生活习惯等采用适合病区特点的降氟除氟技术措施，对建立起地氟病防治的长效管理机制具有代表性和示范作用。

A Baseline Study on the Application of Defluoridation Methods for the Prevention of Bone and Dental Fluorosis

Objective To evaluate the current situation of coal-burning pollution and the occurrence of fluorsis in six model villages adopting fluoride reduction measures. Methods Retrospective analysis on the data collected from the six model villages （in 3 districts） was performed. The prevalence rate, damage rate and the index of fluorine spot tooth were scored with the Dean classification method. Extent of fluorosis was evaluated in the population with an age of 16 or above. The prevalence rate of bone fluorosis and the levels of fluoride in urine of children and in the air were determined. Questionnaire type survey was also conducted to evaluate the extent of stove usage. Results For the population aged 8-12, the prevalence rate, damage rate and the index of fluorine spot tooth was 70.71%, 8.54% and 1.29, respectively. The extent of fluorosis is moderate. For the population aged 16 and above, the positive rate of bone fluorosis was 6.37%, and the percentage of individual with severe bone fluorosis was 0.8%. The level of fluoride in the air was 1.04 mg/L and （0.0037±0.0063） mg/m^3, respectively. And the vigorous phase Mean is （0.0083±0.0067） mg/m^3. The percentage of household using coal, biogas and liquefied petroleum gas was 93.03% （3269/3514）, 1.79% （63/3514） and 5.18% （182/3514）, respectively. The number of household correctly using the stove for cooking was 1 921 （53.29%）. The percentage of students and local residents with the knowledge to prevent fluorosis was 78.16% and 62.95%, respectively. Conclusion Using the coal-burning type stove are common in these selected 6 villages. Adoption of fluoride removal technology is required to reduce the incidence of fluorosis. Promotion of health education, increasing the awareness of fluorosis, and adoption of an appropriate method to reduce the level of environmental fluoride is required for the management and prevention of fluorosis.